Evidence thin on osteopathic manipulation for kids

NEW YORK (Reuters Health) - There is no clear evidence that osteopathic manipulation helps treat kids and teenagers with a range of ailments from asthma to ear infections, according to a new review of the literature.

Researchers found 17 studies that compared children who did and didn't receive osteopathic manipulation, but only five that they considered to be rigorous and well-designed. Of those, just one trial found a benefit for the therapy.

"I think the onus is on osteopaths to show that their claims are not bogus," said Dr. Edzard Ernst, emeritus professor at the University of Exeter in the UK, who worked on the study.

Research suggests between 2 and 3 percent of U.S. children are treated with chiropractic or osteopathic manipulation, making those techniques among the most common types of complementary medicine used by kids.

Studies included in the new review varied greatly, with protocols ranging from a single session of osteopathic manipulation to multiple treatments over weeks or months.

For example, in one study of 57 kids with a history of ear infections, half went to nine sessions of osteopathic manipulation; the others received usual care only. Researchers noted a drop in ear infections among children in the treatment group, but no clear change in antibiotic use - and the study had a high drop-out rate.

Most of the trials only included a small number of kids. Patients or doctors often knew who was being treated with osteopathic manipulation and who was in a comparison no-treatment group - which can bias how treatments are rated.

More than half of the studies also did not report how many kids had side effects related to osteopathic manipulation.

Across the board, seven of the studies found a benefit with osteopathic manipulation - including on asthma symptoms, colic and ear infections - and seven did not. The remaining three studies did not directly compare kids in the different treatment groups.

Ernst, whose team published its findings Monday in Pediatrics, said osteopathic manipulation may cost up to $125 per session.

Dr. Miriam Mills, a pediatrician who studies osteopathic medicine at the Oklahoma State University Center for Health Sciences in Tulsa, said lack of funding is one of the main barriers to new research in her field.

"The osteopathic community is acutely aware of the need to get serious about doing more serious research," Mills, who wasn't involved in the new study, told Reuters Health.

She said osteopathic medicine can be especially helpful for kids, and sees it benefit those with colic, feeding problems and concussions - though traditional doctors remain skeptical.

"This is just basic, move this around and you free up the joints stuff. It's not rocket science," Mills said.

"It's not in the literature, and that's sad, but the patients know it works."

Still, Ernst told Reuters Health by email, "Until this evidence is available, osteopathy cannot be regarded as an evidence-based treatment."